Glomerulonephritis
What is Glomerulonephritis?
Glomerulonephritis is a group of diseases
that injure the part of the kidney that filters blood (called
glomeruli). Other terms you may hear used are nephritis and
nephrotic syndrome. When the kidney is injured, it cannot get
rid of wastes and extra fluid in the body. If the illness
continues, the kidneys may stop working completely, resulting in
kidney failure).
Are there different types of
glomerulonephritis?
Yes. There are two types of
glomerulonephritis—acute and chronic. The acute form develops
suddenly. You may get it after an infection in your throat or on
your skin. Sometimes, you may get better on your own. Other
times, your kidneys may stop working unless the right treatment
is started quickly. The early symptoms of the acute disease are:
- puffiness of your face in the morning
- blood in your urine (or brown urine)
- urinating less than usual.
You may be short of breath and cough
because of extra fluid in your lungs. You may also have high
blood pressure. If you have one or all of these symptoms, be
sure to see your doctor right away.
The chronic form may develop silently
(without symptoms) over several years. It often leads to
complete kidney failure. Early signs and symptoms of the chronic
form may include:
- Blood or protein in the urine (hematuria,
proteinuria)
- High blood pressure
- Swelling of your ankles or face (edema)
- Frequent nighttime urination
- Very bubbly or foamy urine
Symptoms of kidney failure include:
- Lack of appetite
- Nausea and vomiting
- Tiredness
- Difficulty sleeping
- Dry and itchy skin
- Nighttime muscle cramps
What causes acute glomerulonephritis?
The acute disease may be caused by
infections such as strep throat. It may also be caused by other
illnesses, including lupus, Goodpasture’s syndrome, Wegener’s
disease, and polyarteritis nodosa. Early diagnosis and prompt
treatment are important to prevent kidney failure.
What causes chronic glomerulonephritis?
Sometimes, the disease runs in the family.
This kind often shows up in young men who may also have hearing
loss and vision loss. Some forms are caused by changes in the
immune system. However, in many cases, the cause is not known.
Sometimes, you will have one acute attack of the disease and
develop the chronic form years later.
How is a diagnosis of glomerulonephritis
made?
The first clues are the signs and
symptoms. Finding protein and blood cells in your urine is
another sign. Blood tests will help the doctor tell what type of
illness you have and how much it has hurt your kidneys.
In some cases, a test called a kidney
biopsy may be needed. In this test, a tiny piece of your kidney
is removed with a special needle, and looked at under a
microscope. A biopsy will help the doctor plan the best
treatment for you.
Can glomerulonephritis be prevented?
Not until more is known about its causes.
However, good hygiene, practicing “safe sex” and avoiding IV
drugs are helpful in preventing viral infections such as HIV and
hepatitis, which could lead to this illness.
If you have the chronic type of
glomerulonephritis, it is very important to control your blood
pressure since this may slow down kidney damage. Your doctor may
tell you to eat less protein. A dietitian trained to work with
kidney patients (a renal dietitian) can be very helpful in
planning your diet.
What treatment is available for
glomerulonephritis?
The acute form may go away by itself.
Sometimes you may need medication or even temporary treatment
with an artificial kidney machine to remove extra fluid and
control high blood pressure and kidney failure. Antibiotics are
not used for acute glomerulonephritis, but they are important in
treat other forms of disease related to bacterial infection. If
you illness is getting worse rapidly, you may be put on high
doses of medicine that affect your immune system. Sometimes,
your doctor may order plasmapheresis, a special blood filtering
process to remove harmful proteins from your blood.
There is no specific treatment for the
chronic form of the illness. You doctor may tell you to:
- Eat less protein, salt and potassium
- Control your blood pressure
- Take diuretics (water pills) to treat
puffiness and swelling
- Take calcium supplements
What is nephrotic syndrome?
Nephrotic syndrome (also called nephrosis)
happens when your kidneys start losing large amounts of protein
in your urine. As your kidneys get worse, extra fluids and salt
build up in your body. This causes you to have swelling (edema),
high blood pressure and higher levels of cholesterol. Nephrotic
syndrome may come from kidney diseases or from other illnesses
such as diabetes and lupus. Some medicines, IV drug abuse and
HIV (the AIDS virus) may also cause it. Sometimes, nephrotic
syndrome goes away after treatment. Other times, this condition
may last for many years and eventually lead to kidney failure.
What treatment is available for nephrotic
syndrome?
Your doctor may tell you to take
prednisone. This medicine helps cut down protein loss. If
prednisone does not work, your doctor may suggest medicines that
affect your immune system. These are especially helpful in
children and adults with a form of the disease called membranous
glomerulonephritis.
Your doctor may also suggest:
- A low salt diet
- Diuretics (water pills)
- Blood pressure medications.
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See also in this A-Z guide:
- High Blood Pressure: How is it Treated?
- Nutrition and Chronic Kidney Disease
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